Category: Mass Media

Transparency during Outbreaks-a Balancing Act?

Communicating about a potential public health concern can put a national voice in a tricky position. This was the situation the Indian government found itself in earlier this year when isolated cases of Zika broke out in the state of Gujarat.

Some argue that it is absolutely essential for the government to keep the public aware of even threats deemed low, as a step towards increased preparedness in the event of an outbreak (Scroll.In). The New York Times cites Dr. Swaminathan, the director-general of the Indian Council of Medical Research, as justifying the lack of communication as rooted in a need to prevent undue panic. Similarly, the Wire interviewed Dr. Ravindran, the director of emergencies in the Ministry of Health and Welfare , who reports that as the WHO did not declare ZIKA as a continued PHEIC (Public Health Emergency of International Concern), the government was not obligated to report these cases, as noted in the International Health Regulations. The cases were reported after being further investigated.

Which brings us back to a question of responsibility: What guides risk communication?

A document published in March 2016 by the WHO provides some guidance. They define risk communication as “the real-time exchange of information, advice, and opinions between experts, community leaders, or officials and the people who are at risk”. It goes on to identify who the at-risk populations are, the best channels for communication, and guidelines on content. By and large, it stresses the point that risk communication has the goal of empowering, above and beyond informing.

Social media have had a significant positive impact in real-time health communication in recent years. For instance, SMS/Tweets were used to identify vaccination locations during the 2009 H1N1 outbreak. On the other hand, such a large volume of information can be difficult to manage. An example of this chaos was witnessed in the Fall of 2014, when the United States saw an Ebola outbreak (Ratzan, 2014).

All to say…risk communication requires deliberation and thoughtful consideration. While the Zika cases in India continue to be a story that sparks a lot of push-back, rightfully so, it’s important to see the flip side of that coin.





Is Health Advertising Worth the Cost? You Be the Judge.

From a small printed flyer to a 30-second T.V. spot during the Super Bowl, there’s no question that advertising is expensive. And while there are many different forms of getting the word out, there are different reasons we advertise as well. It’s safe to say most advertising or marketing, particularly on a large scale, is done for competitive reasons—to boost sales and detract potential customers from going someplace else. But what about when the product being advertised isn’t actually for sale? What’s the goal of marketing something if you aren’t going to profit financially?

In the health communication field, organizations choose to advertise as a means of communicating something to the general public. This could be a health message to get tested for HIV or a celebrity testimonial to stop domestic violence. Either way, in health communication, the the “seller” or advertiser doesn’t stand to gain a profit on their effort in the financial sense, but rather, to promote healthy behaviors that in the long term, save lives. But these ads aren’t cheap. As health communicators, how do we know when the message we’re promoting is effective at producing change for the better?

That’s just what research economist Paul Shafer is trying to determine. A doctoral student in health policy and management, Shafer is working to determine the effectiveness of tobacco cessation advertisements from the Tips From Former Smokers campaign. The ads aired from March 4 to June 21, 2013. To determine effectiveness, Shafer and his colleagues looked at web traffic and determined the number of unique visitors the site had during the time the ads were aired.

The federally funded national tobacco education campaign resulted in the Centers for Disease Control’s (CDC) campaign website having over 900,000 total visits and nearly 1.4 million page views. There were an additional 660,000 unique visitors, meaning users returned to the site after their initial visit.

In his paper, published online Feb. 17, in the Journal of Medical Internet Research, Shafer seeks to demonstrate the relationship between the amount of advertising and the resulting numbers in web traffic. He attempts to show that by increased advertising leads to increased traffic, for both new and returning visitors, thus, implying the advertisements are effective at least getting people’s attention.

Shafer explains the uniqueness of his study is that he and his researchers were able to record the variation of media dose over time and across markets, as opposed to comparing aggregated traffic before, during, and after the campaign.

In addition, he and his team were able to determine fluctuation between the two types of ads, both aimed at providing resources to smokers desiring to quit. The ads used different tagging methods, such as a URL or a telephone hotline number, with results showing that the URL ads were more effective at driving users to the website, but that the hotline ads were also effective at increasing web views.

While Shafer’s study makes it difficult to determine the number of individuals who quit smoking as a direct result of the ads, the study does imply that such campaigns not only serve as a call to action, but also are effective at linking people to resources they would otherwise likely not know about. Finally, the results of the study imply the potential researchers have at more accurately forecasting the impact such ads will have at increasing web usage and interest in online resources that promote healthy behaviors.

So, aside from the fact that health campaigns can be quite expensive to implement, and there are no guarantees of success, with careful formative research and a targeted approach, such campaigns are valuable for the potential they have at impacting populations on a large scale at changing behaviors for good.

How the Super Bowl Tackled Public Health Issues

If you were one of the 112 million people watching the Super Bowl this past weekend, you probably are familiar with the variety of commercials that aired during the big game. From Mountain Dew’s bizarre “puppymonkeybaby” ad to Heinz’s adorable ad featuring a stampede of wiener dogs, advertisers undoubtably provided a diverse lineup this year.

Although the purpose of many of these commercials was to promote products and create brand awareness, advertisers also used the big game as an opportunity to tackle a few public health issues, most notably domestic violence and drunk driving.

First, nonprofit NO MORE partnered with the NFL for the second year in a row to bring issues of domestic violence into the spotlight (just in time for Teen Domestic Violence Awareness Month) with their chilling ad. The ad featured a text conversation between two friends that addressed how bystanders can play a role in stopping abuse. While the ad received a lot of criticism for failing to address the number of NFL players who face domestic abuse accusations, just the fact that this type of ad aired for such a large audience is a positive.

Then, Budweiser attempts to stigmatize drinking and driving with it’s more light-hearted ad featuring Helen Mirren. In this commercial, 70-year-old British actress slams drunk drivers by calling them, ” short-sighted, utterly useless, oxygen wasting, human form[s] of pollution,” among other things.

All in all, having public service announcements like these air during the most-watched sporting event in the U.S. is a crucial step that will hopefully pave the way for many more to air in the years to follow. What other issues do you think the Super Bowl should tackle?

Signposts for Science News

When finding news about science and health is as easy as a tap of your fingertip, it’s easier than ever to be up to date on the latest discoveries or policy issues. Unfortunately, it is almost as easy to become misinformed. Follow these three tips to help become a savvy science news consumer.

  1. WARNING: Sources that use “cause.” A lot of times, news sources will simplify findings of a study to either make it sound more interesting or because the actual results are more nuanced and complex than what can fit into a short-form post. Because of this, you’ll see the internet peppered with inaccurate science and health news. For instance, there has been a lot of coverage on the how marijuana use is associated with psychiatric illness. While there are studies that find this association, some news sources go as far as to purport that “cannabis can trigger schizophrenia.” Most of these kinds of findings are actually correlational, which only means a relationship was found, not (necessarily) that one causes the other.
  2. CAUTION: Potential future therapies. As a science writer, I will admit I’m guilty of writing this one. Sometimes we get excited when we read news that a mechanism underlying Alzheimer’s disease was discovered, so we naturally search for the next step. Remember that research is slow, and while the human race has truly accomplished incredible things, even within the past ten years, don’t get your hopes up that a new discovery will mean you or your family’s health issues will be over soon.
  3. YIELD: Check your source’s source. We live in a fast-paced 24-hour news cycle world. This means journalists have to churn out information quickly and often. To meet all the demand, websites will cover the same stories, which is great because this means news can reach all different audiences (from tech-savvy consumers of Gizmodo, to moms skimming the AOL news headlines, to people paying subscriptions for New York Times online). However, if you really want to know what the original research is about, you need to go to the source, or at least the press release issued by the university or institution. Oftentimes, websites will link to each other instead of the original article or press release! This can turn into an interesting game of “telephone” where the original message gets passed on so many different times so that the first meaning is highly distorted.

Warning: E-Cigarette Advertising Increases Urge to Smoke

While controversy surrounds the fact that e-cigarettes are often promoted as a safe alternative to tobacco cigarettes, a recent study shows their advertising may be more dangerous than the products themselves. Researchers at the Annenberg School for Communication University of Pennsylvania found that visual depictions of e-cigarettes in advertisements actually increase daily smokers’ urge to smoke cigarettes and may lead to an increase in actual smoking behavior.

Although tobacco advertising has been banned from television and radio in the United States since 1971; electronic cigarettes, because they don’t use tobacco directly, are not subject to this same restriction. As a result, advertisements promoting e-cigarettes have increased substantially in the last five years.

Given the visual similarities of vaping e-cigarettes and smoking tobacco cigarettes, researchers set out to find out whether visual depictions of vaping would serve as smoking cues, and create a greater urge among daily, intermittent, and former smokers to smoke tobacco cigarettes.

Participants in the study were randomly assigned to either view three e-cigarette advertisements containing visual smoking cues, three without visual smoking cues, or no advertisements at all. They then answered questions about their urge to smoke, their belief that they have the ability to quit smoking, and their attitudes and intentions to quit smoking. What they found was not surprising.

Results not only showed that visual depictions of vaping in commercials increased smoking urge among daily smokers, but also that former smokers exposed to vaping cues reported lower intentions to continue to abstain from smoking. While intermittent smokers did not show any significant differences, researchers attribute this to the fact that their smoking is more situation specific, therefore the ads did not affect them.

While it is clear that more research needs to be done in this area, this study is one of the first of it’s kind to prove the harmful affects of vaping cues and is a big step in the movement towards a ban on e-cigarette advertising.



Public Health vs. Public Hysteria

Guest Blogger: Sophia Bernazzani

The recent Ebola outbreak claimed thousands of lives and brought West Africa to its knees. While the fight to stamp out the disease continues, many in the public health community are blaming the media for inciting public hysteria about its possible spread in the United States. Misinformation about the disease heightened anxiety among news media consumers, but failed to improve understanding.

For many AmA burial site was opened on 23 December 2014 in the Disco Hill district to ensure that Ebola victims from Monrovia and the surrounding counties could be buried in a safe and dignified way. The cemetery is a much needed addition to the region since many Liberians were not seeking treatment or informing about the death of loved ones out of fear, their bodies would be cremated - a practice to which many Liberians are opposed out of cultural reasons. Global Communities, in partnership with the USAID Office of U.S. Foreign Disaster Assistance and the Government of Liberia secured the land for the site which is located less than an hour from Monrovia. The site includes Muslim and Christian sections, a temporary morgue, structures for administrative functions, sufficient parking space and an isolated disinfection area. Eventually the 25-acre site will have the capacity to accommodate 13,000 individual graves. While Global Communities is managing the site and continuing construction during the initial phase, management will be fully transitioned to the Government of Liberia when the construction is completed and the virus is under control, There are now 5 burial teams and disinfection teams working at the burial ground. They manage all aspects of dead body management and are trained in the same World Health Organization (WHO) methodology and standards as other burial teams around the country. Disco Hill, Liberia, on 26 January 2015 Photo: UNMEER/Martine Perretericans eager to become more informed about the disease, accurate and responsible reporting took a back seat to sensationalist headlines, menacing graphics and the dissemination of erroneous information. As a result, hysteria, anxiety and panic ensued, leaving many to conclude that an Ebola epidemic throughout the country was imminent. Headlines like “Ebola: The ISIS of Biological Agents” on CNN, or “Broader U.S. Ebola Outbreak ‘Inevitable’?” on Fox News were commonplace. But cable news outlets were not the only culprits. Even respected news magazine Bloomberg Businessweek chose to illustrate their September 14, 2014, cover with “Ebola is Coming,” written ominously in dripping blood.

The stories behind the headlines are now beginning to reveal themselves, and within these stories are not only glimpses of heroism, but also lessons that need to be learned for nearly every sector touched by this public health emergency.

MPH@GW, the online Master of Public Health from the Milken Institute School of Public Health at the George Washington University, is featuring stories that provide a glimpse into the narrative that sensationalist headlines did not capture but, in many ways, tell the real story. Learn more about them here.



Dewey Mooring on Three Simple Rules for Marketing Success

Earlier this week, the writers of Upstream had the pleasure of hearing Dewey Mooring, the Vice President of Jennings: Healthcare Marketing talk about three simple rules for marketing success.

Mooring, a UNC alumni, graduated with a B.A. in Radio, TV and Motion pictures in 1993. He started his career in communications at WCHL, a local radio station in Chapel Hill, by helping with the broadcast of Tar Heel basketball and football games.

Fifteen years ago, he decided to join the advertising world, and now as the Vice President of Jennings, he leads the account team, authors strategic plans, creative briefs, and oversees research for various clients including Vidant Health, Cooper University Health Care, Southwestern Vermont Medical Center, and Darmouth-Hitchcock Medical Center, among others.

As aspiring health communicators, we all benefited from Mooring’s valuable advice about successful marketing. He offered these three simple rules to follow:

1.) Know

Get to know your audience. If you don’t understand who you’re talking to, you won’t be successful in talking to them. Mooring suggests creating a persona for your audience in order to best market to them. Give that person a name, an age, a salary, and find out their media interests, like what they watch on TV, what magazines they read, and what brands they like.

2.) Engage

Once you get to know your audience, it becomes important to use this information to engage them. In the world of healthcare, peer-to-peer communication has become a huge trend, especially among online health information seekers. Because of this, finding ways to use social and digital media to connect brands with their target audiences can be a successful strategy. Mooring exemplifies this by talking about the company’s use of a blog for Lowell General Hospital & Floating Hospital for Children titled, Our Circle of Moms, that engages moms in the hospital’s brand by allowing them to connect and share with other moms in the community.

3.) Measure

When working with clients, it is important to not only show them what you spent their money on, but also to justify the money spent with measured results. This can be done by keeping track of visits to websites, how many people signed up for a program after information sessions, and radio and digital reach. Mooring points out that while measuring results is easier than it was before, it can still be difficult in the area of healthcare, as the majority of hospital services and treatments do not lend themselves to immediate action by consumers.

What is Movember?

My boyfriend has always been a fan of No-Shave-November, mainly because of his love for his scruffy beard all year-long. But this year, he told me he was doing something different. He was shaving his beard on November 1st to instead grow out a mustache all month long. While at first I cringed at the thought of him sporting a dying 1970s trend, once I learned more about the organization behind this attempt at a mustache comeback, I became more supportive.

Movember, the month formerly known as November, marks a month where men and women join together to bring men’s health issues, a topic often neglected, into the spotlight. Men, called “Mo-Bros” sign up and grow and groom a mustache for 30 days. The organization has also made efforts to get women (called “Mo-Sistas”) involved, so they can also raise money and awareness to support the men in their life (without growing the mustache). 

You may be wondering, how does a mustache help with men’s health issues? Well, the idea behind the Movember Foundation is that a mustache is nature’s billboard. The founders discovered that the mustache is a powerful way to start conversations and decided to use that idea to get men more comfortable talking about their health. What most people don’t realize is that the state of men’s health is in a crisis, and on average, men die six years earlier than women. Some of the main causes of death in men (suicide, prostate cancer, and testicular cancer) are a result of the stereotypical forms of masculinity that prevent men from seeking help or getting preventative care.

Since the foundation of the project in 2003, the organization has grown from just 30 “Mo-Bros”, to 5 million “Mo-Bros” and “Mo-Sistas” worldwide. They also have raised $649 million and have funded over 832 men’s health projects since 2003.

So no, mustaches are not making a comeback (thank god), but they are making a significant contribution to men living happier, healthier, longer lives. For more information about the foundation, or to sign up for your own Movember (it’s not too late!) visit

Today is National Healthy Eating Day

New Years Day is not the only day you can commit to a healthier lifestyle – why not start today? Today marks the American Heart Association’s 7th annual National Healthy Eating Day, a day where millions of people throughout the United States come together and make a pledge to take steps toward living a healthier life. A healthy diet and lifestyle are vital in the fight against cardiovascular disease, the global leading cause of death accounting for 17.3 million deaths per year.

For many people, the idea of starting a healthy lifestyle can be both daunting and overwhelming, but the truth is, it’s a lot easier than you think. However, it’s important to keep in mind that lifestyle changes don’t happen overnight, so remember to just take it one day at a time. Here are some simple changes you can make each day to begin your commitment to a healthier life:

Day One: Opt for a fruit and vegetable filled lunch today. Fruits and vegetables are high in nutrients, minerals and vitamins and low in calories. Today for lunch, have a hearty vegetable filled salad with a piece of fruit, or fill your sandwich with vegetables and opt for raw veggie sticks instead of chips.

Day Two: Make the whole-grain swap. Many whole grains are good or excellent sources of dietary fiber and can lower risk of heart disease, stroke, obesity and type 2 diabetes. For breakfast, choose a whole grain english muffin or whole grain cereal over refined grains like corn cereal and white toast. For lunch or dinner, try swapping out white rice for brown rice or quinoa.

Day Three: Cut down on sugar. Sugar is filled with empty calories that can lead to weight gain and high blood sugar levels. Today, swap out your soda or juice for a sugar-free beverage like flavored seltzer, green tea, or just water!

Day Four: Cut down on red meat. Generally, red meats have more cholesterol and saturated fats (big contributors of heart disease) than other proteins like chicken, fish and beans. While it’s still OK to have red meat, it’s important to limit the amount. For dinner tonight, try one of my favorite heart-healthy chicken and bean dishes here.

Day Five: Get moving. While healthy eating and nutrition is an important part of living a heart-healthy life, being physically active is also an important part of preventing both heart disease and stroke. Today, take thirty minutes out of your day and go for a jog, or a bike ride, or take workout class at your local gym. If you don’t think you can make 30 minutes, start small and work your way up.

For more resources and information about National Healthy Eating Day, register for your free toolkit here.

Wellness Wednesdays: The Importance of Body Image

In the past week, several ‘Instagram celebrities’ have shut down their accounts and opened up about some of the unpleasant ‘realities’ of social media. I have a great deal of respect for these young women, some of whom are walking away from sizable paychecks – it takes a lot of guts just to be honest in today’s image-obsessed world. I commend them for calling attention to the negative effects of social media, for the unrealistic expectations that it helps to promote and maintain for young men and women all over the world. Because social media isn’t ‘real life’ – and I think that many people have forgotten that.


I was never very comfortable with my body growing up – I was short, and pudgy, with chubby cheeks and nerdy round glasses. Once I started swimming competitively in middle school, my body image issues got even worse – the skimpy Speedo I wore for several hours each day didn’t exactly provide much  coverage to hide behind. My sister and I both participated in sports that emphasized aesthetics – she was a nationally-ranked gymnast for a number of years, until repeated injuries caused by relentless training forced her to leave the gym.


I kept swimming through my senior year of high school – since then, I can count the number of times I’ve been in a pool on one hand. But I kept up a strict exercise regimen throughout college – the picture at the top of this post was taken shortly after I graduated. I remember the sense of brutal satisfaction I took in manipulating my body, subverting it to my ‘will’ – I had an unhealthy relationship with food at the time, one that I’ve struggled with for much of my life.


It took meeting my wife, and my in-laws, to change some of those bad habits. In their culture, food meant family – and love. Refusing a meal was tantamount to a slap in the face; certainly not an option when one is trying to make a good impression.


Food is as commonly featured on social media as are scantily clad bodies – seemingly a contradiction, and certainly one that sends mixed messages to those still trying to find their place in a judgmental world. It took me a long time to find my place, and I’m grateful that I grew up without Facebook and Instagram to further fuel my own dissatisfaction. When I look in the mirror now, I try to embrace my ‘flaws’, instead of denying them. I remember that this is reality, unfiltered – and everything else is just a mirage.